10D2088658 CLIA NUMBER - PUBLIX PHARMACY #0497

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Laboratory Demographics

CLIA Number: 10D2088658

Facility Name: PUBLIX PHARMACY #0497

Facility Address:
36301 EAST LAKE RD
PALM HARBOR, FL
ZIP 34685
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Facility Phone Number: 727 785-8837

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700826187

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	10D2088658
LAB Type	Pharmacy
Facility Name	PUBLIX PHARMACY #0497
Street	36301 EAST LAKE RD
City	PALM HARBOR
State	FL
ZIP	34685
Phone	727 785-8837
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024